RB26067.

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Progress Payment Certificate

Subcontractor

Certificate No.

Purchase Order No.

Date

Job No.



Purchase Order Value
(original)

(excl. tax)
Currency

P.O. Value through amendment
No.

(excl. tax)

Description Work included in
Form of Tender
Value of Extra Work
Authorization
Total Value
(F.O.T. + E.W.A.)
Value of subcontractors work
completed to date




Gross value of work completed to
date


Deduct retention at the rate of

%


Net value of work completed to
date



Deduct previous payments


Amount due for payment
(excl tax)




Invoice No. Date Amount










Certified that the amount stated above is now due to the subcontractor in accordance with the terms of the contract.
Accepted for Company
Subcontracts/Control Manager

Date


Project Construction Manager

Date


Accepted for Client

Date